Camp Viking

@ North Canton YMCA

CDC/Portage Building

Grades entering 1-8

Camp Eagle

@GlenOak High school

Grades entering 1-5

June 4th-August 17th (Monday-Friday) 9am-4pm

EXTENDED HOURS AVAILABLE! 630-9a & 4-630p

The completed registration

packet and payment for the

first week must be

received before your child may

attend. ALL OUTSTANDING

BALANCES MUST BE PAID IN FULL

before your child can be registered

for Summer Day Camp.

CHOOSE YOUR ADVENTURE!

North Canton YMCA Day Camp

Day Camp

THINGS TO REMEMBER:

Camp Viking-need a packed lunch

everyday (Camp Eagle do not)

Shoes and socks are a MUST

Apply sunscreen prior to arrival

Bring a Water bottle

Your camper WILL get messy

Bring swimsuit/towel everyday

Payment is due by the Friday for the

Camp

Viking

Camp

Eagle

“Like” Us on Facebook

(North Canton YMCA Child Development Center)

Day Camp Names: At each site, we named our Day Camp programs the

following:

North Canton site–

Camp Viking

GlenOak High School site–

Camp Eagle

NEW TO CAMP! Group Names:

1st and 2nd graders

(formally Jr. Day Camp) are now...

EXPLORERS

3rd, 4th, and 5th graders

(formally Day Camp) are now...

TRAILBLAZERS

6th, 7th, and 8th graders

(formally Camp Mid) are now…

RANGERS

SPECIALTY CAMPS

Located at Camp Viking

Art Camp-Bring your creativity to this week-long art

immersion camp! Campers will explore different

techniques and create works of art to be displayed in

an art show at the end of the week. This camp is

offered at Camp Viking for campers entering grades 1-

3 and 4-8 during separate weeks.

Lego Camp-Ready, set, BUILD! Test your skills during

this week of Lego challenges. Lego Camp is offered at

Camp Viking for campers entering grades 1-3 and 4-8

during separate weeks.

Tae Kwon Do Camp-Whether you’re a beginner or

experienced in Taekwondo, this camp will have you

kickin’ it by the end of the week! Campers will work with

a Taekwondo master in this immersive camp. This camp

is offered at Camp Viking for campers entering grades

1-8 during the same week.

Stem Studio-Campers get creative with science,

technology, engineering and math activities during this

hands-on camp! This camp is offered at Camp Viking for

campers entering grades 1-3 and 4-8 during separate

weeks.

NASA Camp- Blastoff with this space-based

immersion camp! Campers learn about physics as they

design and launch rockets this week! This camp is

offered at Camp Viking for campers entering grades 4-8.

Located at Camp Eagle

Kids in the Kitchen-Master your culinary skills at cooking

camp! Campers will learn about healthy eating, take a behind

the scenes tour of a school kitchen and of course create

yummy dishes! This camp is offered at Camp Eagle during two

separate weeks for campers entering grades 1-3 and 4-8.

Great Race Camp-Race around the “World” in this camp

modeled after The Amazing Race. Campers will experience a

variety of activities through road blocks and speed bumps as

they race to the check points each day! This camp is offered

at Camp Eagle during two separate weeks for campers

entering grades 1-3 and 4-8.

Everyday Heroes-Campers become our Everyday Heroes

during this specialty camp week. They will be fire fighters,

EMS personnel, policemen and other first responders as they

learn what it takes to be a hero! This camp is offered at Camp

Eagle during two separate weeks for campers entering grades

1-3 and 4-8.

Specialty Camps

YMCA of CENTRAL STARK COUNTY

SUMMER DAY CAMP REGISTRATION 2018

CHILD’S INFORMATION

Child’s Name (first/last) ______________________________________________________________ Home Phone # ________________________

Address ______________________________________________________________________________________________________________________________

City_________________________________________________________________________ State ____________ ZIP _________________________________

Male Female Birth date _______/_______/_______ Age __________ Grade (School year 2018/2019) ________________

1st Parent _______________________________________________Birthdate __________________e-mail _____________________________________

2nd Parent _____________________________________________Birthdate __________________e-mail _____________________________________

Marital Status: Married Separated Divorced Single

Custody/Contact restrictions (Equal access to the center and child will be granted to each parent in the absence of a Court order,

which must be provided to the YMCA, specifying otherwise).

___________________________________________________________________________________________

Please list the persons permitted to pick-up your child.

___________________________________ Phone # _______________ Relationship ____________________

___________________________________ Phone # _______________ Relationship ____________________

___________________________________ Phone # _______________ Relationship ____________________

T-Shirt Size (circle one): XS (2-4) S (6-8) M (10-12) L (14-16) AS AM Other_______________

Child’s Camp: Explorers (Grades 1&2) Trailblazers (Grades 3-5) Rangers (Grades 6-8)

Camp Viking

Week of: Member/Non 6/4 6/11 6/18 6/25 7/2 7/9 7/16 7/23 7/30 8/6 8/13

Explorers

1-2 grade $140/160

Trailblazers

3-5 grade $140/160

Rangers

6-8 grade $145/165

Specialty Camp $150/175 Tae Kwon

Do

1-8

Lego

1-3

Lego

4-8

Art

1-3

Art

4-8

STEM

1-3

STEM

4-8

NASA

4-8

Camp Eagle

Week of: Member/Non 6/4 6/11 6/18 6/25 7/2 7/9 7/16 7/23 7/30 8/6 8/13

Explorers

1-2 grade $140/160

Trailblazers

3-5 grade $140/160

Specialty

Camp $150/175

Great

Race

4-8

Great

Race

1-3

In the

Kitchen

4-8

In the

Kitchen

1-3

Everyday

Heroes

4-8

Everyday

Heroes

1-3

**Part day rate available for children enrolled in Plain Local enrichment classes.

Our goal is to set guidelines to develop a feeling of self-worth and competence for each child that results in social and emotional

growth. The Y has developed a set of expectations that are developmentally appropriate for their group of campers. The Camp

Director/Counselors will review these rules with the groups and they will be posted. YMCA rules are expected to be followed both in

and outside of the Y building and at all times the child are in the Day Camp program.

Our disciplinary steps are based on an understanding of the individual child’s needs and stage of development as well as each

individual situation. It is our desire to help each child develop self-control, and respect for the rights of others. Please provide staff

as much information as possible about your child at the beginning of camp and throughout their time in the program to help inform

this process.

When behavior management problems arise, staff will use a problem-solving approach to support children in resolving conflicts. Staff

will approach the situation calmly, stopping any hurtful actions or language. When the situation is calm, staff will gather information

from the children involved and any others that witnessed the incident. Staff will also ask the children for ideas for a solution and how

to properly handle the situation next time.

At no time will any form of corporal punishment or shaming be used. Children are never deprived of food as a form of discipline. The

entire group is not punished for the actions of one or a few. Children are not restricted from activities for extended periods of time.

Please initial each statement and sign below:

I understand that in a crisis situation, my child may be physically held to prevent bodily harm to self

and/or others, or the destruction of property. Physical holding shall be utilized for the minimum frequency and

duration possible and shall not be used as punishment, convenience for staff, or as a means for compliance with

behavioral expectations.

Abusive language or actions of parents may result in immediate dismissal of the child from programming.

I have read and understand the above Behavior Guidance/Management Policy.

SIGNATURE ____________________________ DATE ______ (Parent or Guardian)

Behavior Management Reports and Procedure:

When a behavior concern arises, staff will utilize the Behavior Management Report to document the incident and report to

parents/guardians. This form addresses the following behaviors with room for additional situations.

Refusal to follow rules/cooperate with staff

Leaving the group or staff without permission

Continuous disruptive behavior

Stealing/damaging of property

Use of profanity, vulgarity or obscenities

Endangering the health and safety of self, other children and/or staff

Teasing/bullying of other children or staff

Fighting of any kind

Staff will follow the below procedure for these incidents with campers:

First Report: Written warning and parent/guardian will be contacted.

Second Report: The student will be sent home and serve a suspension. Parent/Guardian will be contacted and must

discuss with Director.

Third Report: The student will be sent home and serve a suspension. Child cannot return until parent/guardian meets with a

director to develop a specific behavior management plan.

Fourth Report: The student will be removed from the program and services will no longer be provided.

When there are recurring problems, sufficient attempts to follow the above steps have failed, and/or the behavior involved may

result in unsafe conditions for the child, others or the program environment, immediate removal from the program may be

necessary. These situations will result in an immediate “pick-up” and the child care director will determine the most appropriate

next step. Each YMCA location reserves the right to skip steps in this process as deemed necessary. If removed from the program,

campers will not be re-admitted to any child care program with YMCA of Central Stark County, unless specific exception is made at

the time of the request.

BEHAVIOR GUIDANCE/MANAGEMENT POLICY

Child’s Name: Child’s Date of Birth: ____

Y N I give permission for my child to be included in publicity pictures connected with the program, including

those used in online media such as on our website and Facebook page.

Y N My child is up to date on all vaccinations required by the Department of Health.

His/her last tetanus vaccination was received on ______/______/______.

I, the undersigned parent/guardian, do hereby accept all responsibility for, and assume the risk of any injury or

damage to my person or dependent children which might arise directly or indirectly as a result of, and/or participation

in a YMCA of Central Stark County program. I hereby expressly release, discharge and hold harmless from any liability

whatsoever the YMCA, the various branches and subdivisions expressly including but not limited to the Board of

Trustees of the YMCA, except for injuries caused intentionally, or by willful misconduct. I certify that I am familiar

with the contents of the release, that I have read and understand the same, and that it is my intention by signing this

release that the same be binding not only on me, but my heirs, administrators, executors, successors, and assigns.

The YMCA of Central Stark County is not responsible for misplaced or stolen items. PERMISSION TO TREAT: IN CASE

OF MEDICAL ILLNESS OR INJURY, I hereby give permission to YMCA Day Camp personnel to provide routine health

care, first aid, medication or treatment as determined by medical personnel. IN CASE OF MEDICAL EMERGENCY or

medical care beyond the scope of camp facilities, I understand that every effort will be made to notify listed

contact(s). I authorize YMCA Day Camp personnel to act on my behalf and secure emergency medical treatment and

grant permission to the attending physician to secure proper treatment for the named camper.

Parent/Guardian Signature Date

Grant and United Way Information

Agencies like the United Way allocate funds to the YMCA every year. We use this money to help with financial

assistance to those who need it which in turn keeps fees lower. Please fill in the information requested below to help

the Child Care Programs with our funding requests.

Child’s Gender (circle): Male Female

Child’s Race (please circle one below)

American Indian/Alaska Native Asian Black/African American

Hispanic/Latino Native Hawaiian/Pacific Islander White

Family Size (please circle one): 2 3 4 5 6 7 8

Household Income Level (please check one):

$0-$9,999

$10,000-$19,999

$20,000-$29,999

$30,000-$39,999

$40,000-$49,999

$50,000+

Explorers

1-2

Trail

Blazers

3-5

Rangers

6-8 Specialty Field Trip Time

Parent

Initials

6/5/18 6/7/18 6/6/18

Pump It Up & Quail Hollow State Park**

(1135 W Maple St Hartville OH 330.877.7867/13480 Congress

Lake Ave Hartville, OH 44632)

10a-4p

6/12/18 6/14/18 6/13/18 6/15/18 Uhrichsville Water Park**

(401 E 12th St Uhrichsville OH 740.922.8780) 10a-4p

6/19/18 6/21/18 6/20/18 6/22/18 The Wilderness Center

(9877 Alabama Ave SW, Wilmot, OH 44689 330.359.5235) 10a-4p

6/29/18 6/29/18 6/29/18 6/29/18 Character Olympics @ the Lake YMCA

428 King Church Ave SW, Uniontown, OH 44685 10a-4p

7/3/18 7/5/18 7/6/18 The Farm at Walnut Creek

(4147 Co Hwy 114, Sugarcreek, OH 44681 330.89.4200) 10a-4

7/10/18 7/13/18 Akron Zoo**

(500 Edgewood Ave Akron, OH 44307 330.375.2550) 9a-4p

7/12/18 7/11/18 Cleveland Zoo**

(3900 Wildlife Way, Cleveland, OH 44109 (216) 661-6500) 9a-4p

7/17/18 GlenOak High School/Alpine Community Park (1801 Schneider St Canton, OH 44721 330.491.3800/3059 Alpine St

Canton, OH 44721) 930a-4p

7/19/18 7/17-

7/18

Camp Tippecanoe**^^ EXTENDED DAY for Trailblazers!!

(81300 Steward Rd, Tippecanoe OH 44699 800.922.0679) 8a-6p

7/20/18 Tuscora Park**

161 Tuscora Ave NW New Philadelphia, OH 44663 10a-4p

7/24/18 7/26/18 7/25/18 7/27/18 Beech Creek Botanical Gardens

(11929 Beech St Alliance, OH 44601 33.829.7050) 9a-4p

7/31/18 8/2/18 8/1/18 8/3/18 Uhrichsville Water Park**

(401 E 12th St Uhrichsville OH 740.922.8780) 10a-4p

8/8/18 Canal Fulton Canoeing**^^

(219 OH-93, Canal Fulton, OH 44614 330.854.4008) 9a-4p

8/10/18 8/10/18 8/10/18 8/10/18 North Canton Skate Center (See park info below)

(5475 Whipple Ave NW North Canton OH 330.499.7170) 9a-4p

8/10/18 8/10/18 8/10/18 8/10/18

Explorers- Greensburg Park, 4899 Massillon Rd, OH 44720

TB-Greentown 3696 Apollo St NW, Uniontown, OH 44685**

Rangers/Specialty- Alpine 3059 Alpine St NE, Canton, 44721**

9a-4p

8/14/18 8/16/18 8/15/18

Movies 10 and Boettler Park**

(6284 Dressler Rd NW, North Canton, OH 44720

330.497.9118/5300 Massillon RD NC OH 44720)

9a-4p

6/7,6/28,

7/19, 8/9

6/6, 6/27,

7/18, 8/8

6/4, 6/25,

7/16, 8/6

6/12,

7/10, 7/31

Witwer Park

(Harmon St., North Canton)

9a-2p

Specialty 1230-4

6/14,7/5,

7/26, 8/16

6/13,

7/25, 8/15

6/11, 7/2,

7/23, 8/13

6/19,

7/17, 8/7

Dogwood Park (Specialty Camp at pool )

(241 7th St. NE in North Canton 365 7TH St. NE in North

Canton) (365 7th ST N. Canton OH 44720)

9a-2p

Specialty 1230-4

6/21,7/12,

8/2,

6/20,

7/11, 8/1,

6/18, 7/9,

7/30 6/26, 7/24

Price Park**

(1000 W. Maple Street North Canton) 9a-2p

Specialty 1230-4

To the YMCA to swim (200 N. Main St)** Times Parent Initials

Mon/Wed

6/4/18-

8/15/18

Tues/Fri

6/5/18-

8/17/18

Tues/Fri

6/5/18-

8/17/18

Thursday

6/5/18-

8/17/18

1230-4pm

FIELD TRIP PERMISSION

Camp Viking (North Canton) Explorers, Trailblazers, Rangers, Specialty

CHILD’S NAME _________________________________________ DOB _______________

By initialing & signing below, I hereby grant permission to the North Canton YMCA Day Camp for my child to travel by foot, First

Student bussing or Plain Local Schools Bussing from the North Canton YMCA Child Development Center/Portage Building or

GlenOak High School to the following locations on the dates indicated.

Y N I give permission for my child to participate in swimming activities in the program.

***My child is a _________ swimmer _________ non-swimmer***

My child is _____________ not over 4 years and/or 40lbs _______________ over 4 years and 40lbs ____________ 8 years and/or over 4’9”

*Field Trip schedules are subject to change based on extenuating circumstances.

** Water with a depth greater than 18 inches will be present on the grounds of this trip. ^^Water activities will be planned and participated

The center will provide one additional staff member for every 18 children when we are offsite and one additional staff member per 10 children for swimming

fieldtrips and routine trips. Field trips will leave promptly each day. All children who go will participate in the activities planned on that trip. I understand

that swimming will be part of some of these activities. I understand my child must be at the North Canton YMCA Day Camp by the time listed above on

field trip days or he/she may miss transportation to the field trip location. If this happens, the YMCA will not provide care for my child that day. We will

return from trips by time listed above unless extenuating circumstances arise.

Parent/Guardian Signature _________________________________________________________________________________Date _____________________________

Explorers

(1st/2nd)

Trail Blazers

(3rd, 4th,5th)

Specialty

Camp Field Trip Time

Parent

Initials

6/8/18 6/8/18 Pump It Up & Quail Hollow State Park**

(1135 W Maple St Hartville OH 330.877.7867/13480 Congress

Lake Ave Hartville, OH 44632)

10a-4p

6/15/18 6/15/18 Uhrichsville Water Park**

(401 E 12th St Uhrichsville OH 740.922.8780) 10a-4p

6/22/18 6/22/18 6/22/18 The Wilderness Center

(9877 Alabama Ave SW, Wilmot, OH 44689 330.359.5235) 10a-4p

6/29/18 6/29/18 6/29/18 Character Olympics @ the Lake YMCA

428 King Church Ave SW, Uniontown, OH 44685 10a-4p

7/6/18 7/6/18 The Farm at Walnut Creek

(4147 Co Hwy 114, Sugarcreek, OH 44681 330.89.4200) 10a-4

7/13/18 7/13/18 7/13/18 Akron Zoo**

(500 Edgewood Ave Akron, OH 44307 330.375.2550) 9a-4p

7/20/18 7/20/18 Tuscora Park**

161 Tuscora Ave NW New Philadelphia, OH 44663 10a-4p

7/19/18 Camp Tippecanoe**^^ EXTENDED DAY for Trailblazers!!

(81300 Steward Rd, Tippecanoe OH 44699 800.922.0679) 8a-6p

7/27/18 7/27/18 7/27/18 Beech Creek Botanical Gardens

(11929 Beech St Alliance, OH 44601 33.829.7050) 9a-4p

8/3/18 8/3/18 8/3/18 Uhrichsville Water Park**

(401 E 12th St Uhrichsville OH 740.922.8780) 10a-4p

8/10/18 8/10/18 North Canton Skate Center (See park info below)

(5475 Whipple Ave NW North Canton OH 330.499.7170) 9a-4p

8/10/18 8/10/18 Price Park**

(1000 W. Maple Street North Canton) 9a-4p

8/17/18 8/17/18 Movies 10 and Boettler Park**

(6284 Dressler Rd NW, North Canton, OH 44720

330.497.9118/5300 Massillon RD NC OH 44720)

9a-4p

Every Monday and Wednesday

6/4/18-/13/18 Schneider (Verteran’s park)

(1714 Schneider St. NE Canton OH 44721)

Mon. 930-1145a

Wed. 1230-345p

Every Tuesday

6/4/18-8/14/18 YMCA Community Building

(200 South Main St. N. Canton OH 44720 330.499.2587) 1230-4p

Every Thursday

6/4/18-8/16/18

Dogwood Park and Pool

(241 7th St. NE in North Canton 365 7TH St. NE in North

Canton) (365 7th ST N. Canton OH 44720)

9a-4p

FIELD TRIP PERMISSION

Camp Eagle (GlenOak) Explorers and Trailblazers

CHILD’S NAME _________________________________________ DOB _______________

By initialing & signing below, I hereby grant permission to the North Canton YMCA Day Camp for my child to travel by foot, First

Student bussing or Plain Local Schools Bussing from the North Canton YMCA Child Development Center/Portage Building or

GlenOak High School to the following locations on the dates indicated.

Y N I give permission for my child to participate in swimming activities in the program.

***My child is a _________ swimmer _________ non-swimmer***

My child is _____________ not over 4 years and/or 40lbs _______________ over 4 years and 40lbs ____________ 8 years and/or over 4’9”

For all campers

*Field Trip schedules are subject to change based on extenuating circumstances.

** Water with a depth greater than 18 inches will be present on the grounds of this trip.

^^Water activities will be planned and participated

The center will provide one additional staff member for every 18 children when we are offsite and one additional staff member per 10 children for swimming

fieldtrips and routine trips.

Field trips will leave promptly each day. All children who go will participate in the activities planned on that trip. I understand that swimming will be part of

some of these activities. I understand my child must be at the North Canton YMCA Day Camp or GlenOak H.S. by the time listed above on field trip

days or he/she may miss transportation to the field trip location. If this happens, the YMCA will not provide care for my child that day. We will return from trips by time listed above unless extenuating circumstances arise.

Parent/Guardian Signature _________________________________________________________________________________Date _____________________________

For ALL Camps

Rangers ONLY (6-8 grade)

Schedule and Tuition Agreement North Canton YMCA Child Development Center/Summer Day Camp 2018

Child’s Name ___________________________________________ Start Date of draft_____________________

Are you responsible for entire tuition payment? __________ If “no” please explain

__________________________________________________________________________________________________________________

Payment Schedule (Please check box)

Camp Viking

Week of: Member/Non 6/4 6/11 6/18 6/25 7/2 7/9 7/16 7/23 7/30 8/6 8/13

Explorers

1-2 grade $140/160

Trailblazers

3-5 grade $140/160

Rangers

6-8 grade $145/165

Specialty Camp $150/175 Tae Kwon

Do

1-8

Lego

1-3

Lego

4-8

Art

1-3

Art

4-8

STEM

1-3

STEM

4-8

NASA

4-8

Camp Eagle

Week of: Member/Non 6/4 6/11 6/18 6/25 7/2 7/9 7/16 7/23 7/30 8/6 8/13

Explorers

1-2 grade $140/160

Trailblazers

3-5 grade $140/160

Specialty

Camp $150/175

Great

Race

4-8

Great

Race

1-3

In the

Kitchen

4-8

In the

Kitchen

1-3

Everyday

Heroes

4-8

Everyday

Heroes

1-3

**Part day rate available for children enrolled in Plain Local enrichment classes.

Y N My child will need care BEFORE camp (630-9am, space is limited)

Y N My child will need care AFTER camp (4-630pm, space is limited)

Payment Options

1. Continue my draft from the 2017/2018 school year._______________________________________________

2. Bank Drafting (Please include a voided check)

Weekly Bi-Weekly Checking Savings

Bank ______________________________________________________________________________________________

Bank Address/City/State/Zip ________________________________________________________________

Transit & Rout # _______________________________________________________________________________

Account # ________________________________________________________________________________________

2. Credit Card Draft

Weekly Bi-Weekly

MasterCard VISA Discover American Express

Issuing Bank Name _________________________________________________________________________

Name on Card _________________________________________ Exp. Date ______________

Account # _____________________________________________________________________________________

3. On-line Payments at www.ymcastark.org

Signature Required

Camp Payment Policies

Please initial beside each of the following:

__________ Camp fee payment is due one week in advance of attendance. (Including ODJFS copays)

__________ Accounts that have a balance of 2 weeks or more will be considered delinquent – Y staff will

contact the responsible parent to reconcile the balance and keep the account current. If a payment

agreement is not reached or payment is not made, camp services may be suspended.

__________ Payments/Refunds will be applied to any outstanding Y balances first then to current programming

fees.

__________ The North Canton YMCA Day Camp programs close at 6:30PM. A $1 per minute per child late fee

is charged after 6:30PM.

__________ I understand I will be charged for the program and rate for which I signed up my child.

__________ I understand that weekly tuition is not adjusted for days missed due to illness unless child is

hospitalized.

__________ A 2 week written notice is required for any change in camp schedule, otherwise the account will be

charged based on the schedule for which you signed up.

__________ Failure to communicate with Y staff for 10 business days may result in termination of services.

I will be paying by: Bank Draft Credit Card Draft On-line

______________________________________________________ ___________________________________________________________ _____________

Parent/Guardian Signature Print Name Date

Staff Initials ___________________ Date______________________